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Doctors successfully remove 9 cm tumor from the liver of 5-month-old baby

Thiruvananthapuram, November 14, 2024: A multidisciplinary team at KIMSHEALTH Trivandrum has successfully removed a 9 cm complex tumor from the liver of a 5-month-old baby. The tumor was initially detected during an ultrasound scan when the mother was 33 weeks pregnant, and the infant was delivered via elective C-section at 37 weeks of gestation. A subsequent biopsy confirmed the presence of hepatoblastoma, a rare cancer that forms in the tissues of the liver. This condition is predominantly seen in children but rarely occurs in neonates.

The tumor, which measured approximately 9 cm, was found to be involving critical blood vessels. Given the risks involved, the medical team, led by Dr. Naveen Jain, Senior Consultant, Department of Neonatology, Dr. Azgar Abdul Rasheed, Associate Consultant, Department of Medical Oncology, Dr. Shabeerali T U, Chief Coordinator and Senior Consultant Department of Hepatobiliary, Pancreatic & Liver Transplant Surgery and Dr. Shiraz Ahmad Rather, Clinical Chair, Multiorgan Transplant decided on a multi-step approach involving chemotherapy to shrink the tumor prior to surgery.

"Administering chemotherapy to such a small infant is incredibly challenging," said Dr. Shabeerali T U. "Our objective was to reduce the tumor size to make surgical intervention possible" Despite the challenges of administering chemotherapy to such a young child, the medical team successfully reduced the size of the tumor, and the baby was brought in for surgery at five months old. Due to the complexity of the case, there were initial concerns regarding whether the mass could be surgically removed or if a liver transplant would be necessary. As a precaution, the mother was evaluated as a potential donor but was found to have fatty liver. She underwent lifestyle modifications like diet control and exercises and met the prerequisite to become the donor.

Following another round of chemotherapy, the team proceeded with the surgery, and the doctors could resect the tumor successfully removed without the necessity of a transplant.

The twelve-hour long surgery involved the removal of a major portion of the liver, including the vena cava and the main blood vessel supplying blood to the tumor. The child regained health following the surgery and was discharged a month later. There is very limited experience across neonatal and oncology units in India in managing cancers of newborn babies. Teamwork along with the confidence that the parents placed in the KIMSHEALTH medical team made this beautiful miracle happen, said Dr. Naveen Jain. Besides the chemotherapy dose modifications we had to make because of the baby's age, we also had to account for some jaundice in the first few months, and had issues getting good venous access. The NICU/PICU teams were very supportive, and the parents also took extra precautions to avoid exposing the baby to possible infections, added Dr.Azgar.

Dr. Varghese Yeldho, Consultant, Department of Hepatobiliary, Pancreatic and Liver Transplant Surgery; Dr. Hashir A, Consultant, Department of Anesthesiology; Dr. Manoj K S, Senior Consultant, Imaging & Interventional Radiology; and Dr. Manish Kumar Yadav, Senior Consultant, Neuro Interventional Radiology Imaging & Interventional Radiology, were also part of the team.